Jianhe Liu

Rationale: Premature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment poses a therapeutic dilemma. Traditional Chinese medicine has a long history in arrhythmia treatment, and this is a rare case of an elderly patient with PVC who showed significant improvement after receiving Traditional Chinese medicine treatment. Patient concerns: An 82-year-old male, with a history of mitral stenosis, has undergone surgical mitral valve replacement. This time, he presented with chest pain and palpitations. He was diagnosed with frequent PVCs. Diagnoses: He was diagnosed with PVC by 24-hour Holter monitoring. Interventions: The patient visited The First Hospital of Hunan University of Chinese Medicine on November 4, 2024, and received therapy with Chaihu Sanshen Capsule (CHSSC). Outcomes: After taking CHSSC for 3 treatment courses, the Holter tests showed that the number of ectopic premature beats decreased from 47,730 to 844 within 24 hours. This objective improvement was correlated with significant symptomatic relief, including a pronounced reduction in palpitations and easing of chest tightness. Lessons: This single case observation generates the hypothesis that CHSSC may be associated with reduced PVC burden and symptomatic improvement in elderly patients. Nevertheless, these preliminary findings warrant further investigation through larger prospective studies to establish conclusive evidence.

Background: Heart failure (HF) is a serious clinical syndrome with substantial health threats. Emerging studies link intestinal flora dysbiosis to HF onset and progression. Although probiotics are thought to regulate gut microbiota, the specific impact of probiotics on HF remains unclear, highlighting the need for systematic evaluation. Methods: As of 9 September 2025, we searched eight major academic databases using a predefined protocol for data extraction and quality assessment. Subsequently, a meta-analysis was conducted using Review Manager 5.4 and Stata 18. Forest plots were used to analyse the effect size, and publication bias was evaluated through funnel plots. Results: Ultimately, 11 of the studies met the inclusion criteria for the systematic review. The results showed that probiotics have a slight beneficial effect on cardiac function indicators (LVEF, LVESV), reduced the levels of inflammatory factors (hs-CRP, IL-6, TNF- α ), regulated the proportion of dominant gut bacteria, and decreased the readmission rates of patients with HF. However, no beneficial effects were found on NT-proBNP, activity endurance, TMAO, and mortality. Conclusion: Probiotics exert cardioprotective effects and can serve as adjunctive therapy for HF management. Future high-quality, large-sample clinical studies are needed to further clarify their long-term efficacy and optimal intervention strategies. Systematic review registration: Details of the protocol for this systematic review were registered on PROSPERO (CRD420251083960).

Insulin resistance (IR) is linked to atherosclerotic cardiovascular disease(ASCVD). This study analyzed data from the National Health and Nutrition Examination Survey to reveal the association of IR-related indexes with ASCVD in adults, aiming to improve risk assessment and early intervention. The study included adults from the National Health and Nutrition Examination Survey between 2007 and 2016. We used multivariable logistic regression to assess the link between IR-related indexes and ASCVD. Nonlinear associations were identified using restricted cubic splines and threshold effect analyses. Subgroup analysis confirmed result stability, while receiver operating characteristic curves compared the predictive performance of the indexes. Among 11,687 participants, 9.40% had ASCVD. A linear association between the metabolic score for IR (METS-IR) and ASCVD. The triglyceride-glucose index (TyG), homeostasis model assessment of IR (HOMA-IR), and triglyceride glucose-waist height ratio (TyG-WHtR) had nonlinear correlations with ASCVD prevalence. When TyG > 9.03, it was positively correlated with ASCVD (OR: 1.31, 95% CI: 1.07–1.60). An increase in HOMA-IR < 6.79 correlated with ASCVD risk (OR: 1.08, 95% CI: 1.04–1.12), but when HOMA-IR > 6.79, the increasing trend slowed down. When TyG-WHtR > 5.82, ASCVD risk was increased markedly with increasing values (OR: 1.32, 95% CI: 1.15–1.52), subgroup analysis showed a significant interaction between diabetes status and physical activity. Additionally, TyG-WHtR demonstrated superior predictive capacity for ASCVD (AUC = 0.644) compared to other indexes. Elevated IR levels are independently associated with increased ASCVD risk in American adults, with TyG-WHtR being the strongest predictor.

Background: The benefits and risks of Bifidobacterium compound preparations (BCP) for patients with severe ischemic stroke (SIS) remain unclear. This study aimed to evaluate the efficacy and safety of BCP combined with enteral nutrition (EN) for SIS.Methods: Eight databases were systematically searched for relevant literature up to January 1, 2025. Two researchers independently screened the records, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias Tool 1.0 (RoB 1.0). Meta-analysis, sensitivity analyses, subgroup analyses, and publication bias assessments were conducted with RevMan 5.4 software.Results: Nine randomized controlled trials and 777 patients were included in the analysis. Meta-analysis showed that regarding nutritional status, compared with the EN group, the BCP combination group significantly increased albumin (mean difference [MD] = 4.55, 95% confidence interval [CI], 3.66 to 5.45, p < 0.00001), total protein (MD = 7.40, 95% CI 3.64 to 11.17, p = 0.0001), prealbumin (MD = 46.29, 95% CI 39.60 to 52.97, p < 0.00001), hemoglobin (MD = 10.26, 95% CI 8.09 to 12.43, p < 0.00001), and transferrin (MD = 0.67, 95% CI 0.32 to 1.03, p = 0.0002). Regarding neurological function, the BCP combination group significantly increased the Glasgow Coma Scale score (MD = 1.86, 95% CI 1.17 to 2.56, p < 0.00001) and decreased the National Institutes of Health Stroke Scale score (MD = −2.17, 95% CI −3.35 to −0.99, p = 0.0003). Regarding intestinal barrier function, the BCP combination group significantly reduced diamine oxidase (MD = −0.69, 95% CI −0.87 to −0.50, p < 0.00001) and D-lactate (MD = −0.09, 95% CI −0.11 to −0.08, p < 0.00001). Regarding immune function, the BCP combination group significantly increased IgA (MD = 0.50, 95% CI 0.36 to 0.63, p < 0.00001) and IgG (MD = 3.00, 95% CI 2.03 to 3.97, p < 0.00001). Safety analysis revealed that the BCP combination group significantly reduced the incidence of total adverse events (risk ratio [RR] = 0.28, 95% CI 0.13 to 0.62, p = 0.002), pulmonary infections (RR = 0.51, 95% CI 0.33 to 0.79, p = 0.003), reflux (RR = 0.21, 95% CI 0.05 to 0.92, p = 0.04), and diarrhea (RR = 0.28, 95% CI 0.12 to 0.67, p = 0.005).Conclusion: BCP combined with EN can improve nutritional status, neurological function, intestinal barrier function, and immune function and reduce adverse events for patients with SIS. This approach represents a potential adjuvant treatment strategy for SIS.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420250653156, CRD420250653156.

Heart failure is characterized by progressive energetic insufficiency, in which mitochondrial dysfunction and impaired fatty acid oxidation are central features. Normally, the FAO provides most of the cardiac ATP supply, but in HF, this pathway becomes disrupted, leading to the accumulation of lipid intermediates, oxidative stress, and reduced ATP production. Emerging evidence suggests that mitochondrial impairment and FAO disturbances may interact reciprocally, forming a vicious cycle that aggravates energetic failure and structural remodeling. This review summarizes current knowledge on the bidirectional relationship between mitochondrial dysfunction and FAO abnormalities in HF. We integrate findings from experimental models with clinical observations that highlight the translational relevance of this interplay. In addition, we provide an updated overview of therapeutic strategies, including pharmacological modulators such as SGLT2 inhibitors and trimetazidine, as well as traditional Chinese medicine formulas such as Qiliqiangxin and Qishen granules, which have shown preliminary benefits in clinical studies. Although the proposed vicious cycle remains a working hypothesis requiring further validation, understanding this interplay may help identify novel biomarkers, stratify patients by metabolic phenotype, and guide precision therapies for HF.

Previous studies have shown the potential of Chaihu Sanshen capsule (CHSSC) to ameliorate myocardial ischemia‐reperfusion injury (MIRI), but there is yet no corresponding research on its chemical ingredients and multi‐target action network. The study aims to identify the chemical composition and potential bioactive compounds of CHSSC and elucidate its underlying mechanisms in MIRI treatment. Ultra‐high‐performance liquid chromatography‐Q exactive focus‐mass spectrometry was used to analyse the chemical composition and potential bioactive compounds of CHSSC. The active compounds were analysed via network pharmacology to identify the core targets and pathways. The oxygen–glucose deprivation/reoxygenation (OGD/R) H9C2 cell model and MIRI rat model were established, followed by intervention with CHSSC. TUNEL, flow cytometry and western blotting assays were used to observe the effects of CHSSC on apoptosis, pyroptosis and the PI3K/AKT/p53 signalling pathway, respectively, of cardiomyocytes. In all, 1587 compounds were detected in CHSSC, of which 106 were absorbed into the bloodstream, mainly comprising flavonoids, terpenoids, alkaloids, organic acids, coumarins and phenols. CHSSC primarily targeted TP53, AKT, STAT3, HSP90AA1 and MAPK and involved the regulation of p53, PI3K/AKT, JAK2/STAT3 and MAPK signalling pathways; however, these predicted targets have not yet been validated by confirmatory binding assays. In vitro experiments showed that CHSSC reduced the apoptosis and pyroptosis rates of OGD/R H9C2 cells. In vivo, CHSSC ameliorated myocardial injury in MIRI rats, decreased the cardiomyocyte apoptosis rate, increased PI3K and AKT phosphorylation and inhibited p53 phosphorylation. In conclusion, this study elucidated the potential bioactive compounds and multi‐targets action network of CHSSC in mitigating MIRI, and verified that the effects of CHSSC on MIRI are link to the PI3K/AKT/p53 signalling pathway.

Background: Dengzhan Shengmai Capsule (DZSMC) is a potential treatment for chronic heart failure (CHF). However, its specific benefits in the treatment of CHF remain unclear.Methods: Related randomized controlled trials were searched in eight databases up to January 28, 2025, and included studies were determined according to the inclusion criteria. Subsequently, the basic characteristics and data from these studies were recorded using Excel 2010. Outcome-related data were subsequently imported into Revman 5.3 for meta-analysis.Results: Fifteen randomized controlled trials with 1606 patients were included in this meta-analysis. The results showed that compared to conventional treatment group, DZSMC combination group significantly improved the clinical effective rate [RR = 1.21, 95% CI (1.16,1.26), P < 0.00001], brain natriuretic peptide (BNP) [MD = −112.60, 95%CI (−212.23, −12.96), P = 0.03], N-terminal pro-B-type natriuretic peptide (NT-proBNP) [MD = −88.27, 95%CI (−108.11, −68.42), P < 0.00001], left ventricular ejection fraction (LVEF) [MD = 6.42, 95% CI (5.57, 7.27), P < 0.00001], left ventricular end-diastolic diameter (LVEDD) [MD = −5.72, 95% CI (−7.56, −3.87), P < 0.00001], left ventricular end-systolic diameter (LVESD) [MD = −5.33, 95% CI (−7.41, −3.26), P < 0.00001], left ventricular end-systolic volume (LVESV) [MD = −20.71, 95% CI (−34.59, −6.82), P = 0.003], and 6 min walk test [MD = 51.90, 95%CI (19.08, 84.72), P = 0.002], while adverse events had no significant difference [RR = 0.70, 95%CI (0.42, 1.17), P = 0.17]. Funnel plots indicated no publication bias for BNP, NT-proBNP, LVEF, and LVESD, while potential bias was observed for other outcomes.Conclusion: DZSMC effectively improves clinical symptoms, cardiac function, and ventricular remodeling in CHF patients, with good safety, making it a potential adjuvant therapy for CHF. However, further research is needed to explore the long-term safety of DZSMC in order to enrich clinical evidence.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024507368, PROSPERO [CRD42024507368].

This study aimed to evaluate the causal effects of different immune cells on heart failure (HF) using Mendelian randomization (MR). Datasets for immune cell phenotypes and HF were obtained from European Bioinformatics Institute and FinnGen. Then, single nucleotide polymorphisms were screened according to the basic assumptions of MR. Subsequently, inverse variance weighted was used as primary tool for MR analysis, and Cochran Q and leave-one-out analyses were used to assess heterogeneity and robustness, respectively. MR analysis showed that cluster of differentiation (CD) 66b++ myeloid cell absolute count (AC) (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.001–1.088, P = .045), human leukocyte antigen D-related on CD14– CD16+ monocyte (OR 1.030, 95% CI 1.005–1.056, P = .019), IgD on unsw mem (OR 1.046, 95% CI 1.015–1.078, P = .003), CD4 on CD4+ (OR 1.039, 95% CI 1.009–1.070, P = .011), CD24 on IgD+ CD38– (OR 1.026, 95% CI 1.000–1.052, P = .046), CD20 on CD24 + CD27+ (OR 1.032, 95% CI 1.003–1.061, P = .029), CD19 on CD20– (OR 1.037, 95% CI 1.005–1.071, P = .023), CD62L– CD86 + myeloid dendritic cell %DC (OR 1.032, 95% CI 1.004–1.061, P = .027), human leukocyte antigen D-related + CD4 + AC (OR 1.037, 95% CI 1.003–1.072, P = .032), and effector memory CD8br AC (OR 1.048, 95% CI 1.021–1.076, P < .001) were associated with increased genetic susceptibility to HF. Cochran Q and sensitivity analyses showed that the results had no heterogeneity and were robust. This MR analysis revealed 10 immune cell phenotypes associated with increased genetic susceptibility to HF. These findings provide new directions for understanding the pathogenesis of HF and developing novel therapies.